外眦成形及下睑外翻缝线联合术治疗退行性下睑内翻的效果

 目的 探讨联合外眦成形、下睑外翻缝线以及睑板前轮匝肌切除术治疗退行性下睑内翻的疗效。设计 回顾性病例系列。研究对象 北京同仁眼科中心19例（23眼）退行性下睑内翻患者。方法 手术包括外眦成形矫正水平眼睑松弛，睑板前轮匝肌切除解除眼轮匝肌骑跨，下穹窿皮肤缝线折短下睑缩肌。观察术前术后患者眼睑形态、位置，有无溢泪等。随访8~12个月。主要指标 眼睑形态、位置，有无溢泪。结果 到最后随访时，所有患者下睑对称无畸形；1例患者（1眼）在睁眼时下眼睑与眼表贴附不紧密，但无明显内外翻及溢泪发生。随访期间无复发或过矫现象发生。结论 针对多种致病因素的联合外眦成形、睑板前轮匝肌切除以及下穹窿皮肤缝线术治疗退行性下睑内翻简单有效。

The clinical efficacy of the combined operation for involutional lower eyelid entropion

Objective To evaluate the efficacy of the combined entropion repair for lower eyelid involutional entropion: lateral canthoplasty, excision the preseptal orbicularis oculi, and Quickert suture (LEQ). Design Retrospective case series. Participants Nineteen patients (23 eyes) with lower eyelid involutional entropion underwent the combined procedure in Beijing Tongren Eye Center. Method Surgical technique addressed all 3 anatomic factors underlying the entropion and was performed through a transcutaneous incision. Lateral canthoplasty procedure addressed horizontal eyelid laxity; Quickert suture addressed retractor disinsertion; and excision of a strip of the preseptal orbicularis oculi addressed preseptal orbicularis override. Morphology of eyelid, position of eyelid and epiphora were judged to evaluate the efficiency of this method. The follow-up time was 8~12 months. Main Outcome Measures Morphology of eyelid, position of eyelid, with or without epiphora. Results Transcutaneous LEQ entropion repair resulted in great resolution of involutional entropion in all cases without entropion recurrence or secondary ectropions. Only one case was found that the eyelid failed to contact with the eyeball closely, however, the patient didn’t feel any discomfort. Conclusion The LEQ is a simple and effective operation for the correction of involutional entropion.